Excess Androgens, Congenital Disorders and Male Hypogonadism Flashcards

1
Q

What is hirsutism?

A

Excess hair in a male pattern, in a woman

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2
Q

What causes hirsutism?

A

Excess androgens at the hair follicle

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3
Q

Give 4 causes of hirsutism which present with a long history, fairly normal testosterone and no virilisation?

A

PCOS, familial, idiopathic, non-classical CAH

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4
Q

How does hirsutism as a result of an adrenal or ovarian tumour present?

A

Short history with virilisation

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5
Q

What is non-classical CAH?

A

A partial 21 alpha hydroxylase deficiency which presents in adolescence

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6
Q

How may non-classical CAH present?

A

Hirsutism, menstrual irregularity, infertility

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7
Q

What treatment is used in non classical CAH?

A

Low dose corticosteroid

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8
Q

What are the testosterone levels in an androgen secreting tumour?

A

High (>5)

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9
Q

Which out of adrenal and ovarian androgen secreting tumours are more likely to be malignant?

A

Adrenal

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10
Q

XO is what condition? Which sex does this affect?

A

Turner’s syndrome, only affects girls

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11
Q

What are some features of Turner’s syndrome?

A

Short stature, webbed neck, wide spaced nipples, lymphedema, delayed puberty

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12
Q

What should be screened for in an individual with Turner’s syndrome?

A

Cardiac and renal problems, IBD, osteoporosis and scoliosis

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13
Q

What cardiac problems may Turner’s cause?

A

Coarctation of the aorta, bicuspid aortic valve, hypo plastic left heart

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14
Q

What is XX gonadal dysgenesis?

A

Absent ovaries but no chromosomal abnormalities

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15
Q

What is testicular feminisation?

A

Androgen insensitivity syndrome: genetically XY but phenotypically female

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16
Q

When is a hysteroscopy performed?

A

Only in cases where there is suspected or known endometrial pathology

17
Q

What is the main investigation for pelvic disease?

A

Pelvic ultrasound

18
Q

What are the levels of testosterone and LH/FSH in primary hypogonadism?

A

Testosterone- low, LH/FSH- high

19
Q

What is the most common congenital form of hypogonadism in males?

A

Kleinfelter’s syndrome

20
Q

What is the chromosomal abnormality in Kleinfelter’s syndrome?

A

XXY

21
Q

What are some symptoms of Kleinfelter’s syndrome?

A

Decreased testicular volume, gynaecomastia, intellectual dysfunction, azoospermia

22
Q

Are people with Kleinfelter’s syndrome fertile?

A

No

23
Q

In Kleinfelter’s syndrome, what are the levels of testosterone, LH/FSH, SHBG, oestrogen?

A

Testosterone- low, everything else high

24
Q

What are the levels of testosterone and LH/FSH in secondary hypogonadism?

A

Testosterone- low, LH/FSH- inappropriately low

25
Q

What is the main cause of secondary hypogonadism in males?

A

Hypothalamic/pituitary disease

26
Q

What are some congenital/acquired causes of secondary hypogonadism in males?

A

IHH, Kallmann’s, CAH

27
Q

When is testosterone replacement therapy used in hypogonadism?

A

In young men (< 50)

28
Q

Does testosterone cause prostate cancer?

A

No, but it can exacerbate it if it is already there

29
Q

Will testosterone therapy restore fertility?

A

No

30
Q

What may testosterone therapy help with?

A

Improved sexual function, bone health, body composition, insulin sensitivity, QOL and cognition

31
Q

Gynaecomastia is a result of an increase in what hormone?

A

Oestrogen

32
Q

What are some drugs which may cause gynaecomastia?

A

Oestrogen, testosteron, digoxin, spironolactone